Curb Tobacco Use Research Articles

Environmental Influences on Tobacco Use: Evidence from Societal and Community Influences on Tobacco Use and Dependence

There is little doubt that nicotine addiction sustains tobacco use in most people and that individual variation in response to tobacco has a strong biological basis. However, the great diversity in tobacco use behaviors observed between countries and within countries over time suggests that biology alone cannot fully explain these variations. This review examines the role of the social environment in understanding tobacco use behaviors and efforts to curb tobacco use at the population level. We conclude that the social environment plays a critical role in determining how innate biological factors involved in nicotine dependency actually get expressed at the population level. Tobacco use as reflected in population trends is seen as the product of the interaction of agent, host, and environmental factors. Government policies are seen as an important modifiable environmental influence that can alter how tobacco products are designed and marketed (agent factors) and how consumers perceive the risks and benefits of smoking (host factors). Evidence suggests that synergy is gained when tobacco control interventions directed at agent, host, and environmental factors are implemented together.

Making Hospital Grounds Smoke-Free

The impact of tobacco use and environmental tobacco smoke (ETS) has been well documented. Many policies have been implemented to curb tobacco use and to reduce exposure to ETS. The purpose of this article is to describe the development and passage of Arkansas Act 134 of 2005, the first state law to prohibit the use of tobacco products on the grounds of all nonfederal community (nonpsychiatric) hospital facilities in the state. Efforts to bring this and other tobacco control policies to the attention of policy makers will be discussed in the context of several agenda-setting strategies. The strategy used by stakeholders in Arkansas to bring out Act 134 as well as the other agenda-setting strategies described in the article provide insight into the ways other states and communities seeking to adopt smoking bans and related public health policies can bring such policies to the attention of policy makers.

Talking about…

Talking about…

Smokeless Tobacco and Cigarette Use Among Black Secondary School Students in South Africa

This study was conducted in 2001 with the aim of providing data on black South African secondary school students’ tobacco use status, knowledge, and attitudes. The sample included 330 Grade 10 and 382 Grade 12 secondary school pupils chosen at random from six rural secondary schools in one of the regions in the Northern Province of South Africa. Results show a prevalence of 9.1% current smokers among boys and 5% among girls, and 8.4% current snuff users among girls and 3.9% among boys. The mean age of onset to take snuff was 12.5 years and that for smoking cigarettes 14.8 years. Adolescents who reported that some family member or their peers used tobacco were more likely to be users of tobacco. Two-thirds of the current snuff users believed that using snuff was safer than smoking cigarettes. Knowledge was found to be related to attitude but not with tobacco use behavior. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.

The Question of Cost: Reimbursement and Remuneration

Dentists and the dental team have been encouraged to become an important part of the effort to curb tobacco use. Many health insurance policies, however, do not cover tobacco cessation programs, especially by dentists. The generosity of insurance for tobacco cessation has been found to influence the use of these programs. The dental profession can help by: 1) training more dental students, dental hygienists, and dental practitioners to provide tobacco cessation counseling; 2) increasing the number of practices routinely monitoring tobacco use and providing tobacco cessation programs; 3) increasing the utilization of the available procedure codes for tobacco cessation, whether it is a covered service or not; and 4) stimulating demand for more tobacco cessation coverage by employees.

Tobacco use prevention and cessation programs in the U.S. Navy.

A representative sample of 406 U.S. Navy commands, including all medical treatment facilities, was surveyed in 1990 about their activities and programs to prevent the use of tobacco and promote smoking cessation during the preceding year. The vast majority of Navy commands (86 percent) provided some type of tobacco cessation educational materials or programs. However, the most common activities typically were rated as only "somewhat useful" in helping to curb tobacco use. Almost one-half of all commands offered psychological or behavioral cessation programs. Survey respondents estimated that approximately one-third of those persons who attended such a program stopped their tobacco use and nearly one-half reduced their tobacco use as a result of the program. Over-the-counter smoking cessation aids were not widely available at Navy exchange stores, individual commands, or medical treatment facilities. Furthermore, only 61 percent of all commands reported that they had a written policy or instruction regarding tobacco use. Only about one-third of medical treatment facilities had a routine system for identifying tobacco users by glancing at their medical records. However, it was estimated that 80 percent of medical treatment facility physicians routinely asked their patients about their tobacco use. The authors discuss the need for a more active Navy approach in prevention and cessation efforts and a routine system for identifying tobacco users from their medical records. In addition, inequities in cessation efforts were found among command subgroups.